血清硒蛋白P与老年2型糖尿病合并非酒精性脂肪性肝病的相关性研究

Correlation analysis between serum selenoprotein P and non-alcoholic fatty liver disease in elders with type 2 diabetes mellitus

目的分析老年T2DM患者血清硒蛋白P(SeP)与非酒精性脂肪性肝病(NAFLD)的相关性。方法选取2016年5月至2017年10月于苏州大学附属第一医院内分泌科住院治疗的≥60岁T2DM患者140例,分为T2DM合并NAFLD组(NAFLD组,n=79)和单纯T2DM组(T2DM组,n=61)。检测代谢相关指标及肝酶水平,ELISA检测血清SeP浓度,稳态模型评估胰岛素抵抗指数(HOMA-IR),磁共振多回波肝脏内插容积激发(mLIVE)技术检测肝脂肪含量(LFC)。结果NAFLD组血清SeP高于T2DM组[(1341. 11±290. 51)vs(755. 77±184. 90)ng/ml,P<0. 01]。偏相关分析显示,SeP与LFC、HOMA-IR、LDL-C呈正相关(r=0. 699、0. 613、0. 218,P<0. 05)。Logistic回归分析结果显示,SeP是T2DM合并NFALD的危险因素[OR(95%CI)1. 028(1. 015～1. 041),P<0. 05]。结论血清SeP升高是老年T2DM合并NAFLD的危险因素,且SeP水平与肝脂肪含量呈正相关。

Objective To investigate the correlation between serum selenoprotein P(SeP)and nonalcoholic fatty liver disease(NAFLD)in elders with type 2 diabetes mellitus(T2 DM).Methods A total of 140 patients with T2 DM≥60 years were enrolled in this study,and divided into two groups:NAFLD group(n=79)and T2 DM group(n=61).Serum SeP concentration was measured by ELISA.Routine metabolic parameters and liver enzymes were also tested.Insulin resistance index was calculated by homeostatic model assessment(HOMA-IR),and liver fat content(LFC)was determined with magnetic resonance imaging using the technique of multi-echo liver interpolated volume excitation(mLIVE).Results Serum SeP level was significantly higher in NAFLD group than in T2 DM group((1341.11±290.51)vs(755.77±184.90)ng/ml,P<0.01)Partial correlation analysis showed that serum SeP level was positively correlated with LFC(r=0.699,P<0.01),HOMA-IR(r=0.613,P<0.01)and LDL-C(r=0.218,P<0.05).Binary logistic regression analysis demonstrated that SeP was an independent risk factor for NAFLD in patients with T2 DM(OR(95%CI)1.028(1.015~1.041),P<0.05)Conclusion The serum SeP was an independent risk factor for NAFLD in elders with T2 DM.Serum SeP level was positively correlated with LFC.